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BackgroundClinical decision support systems (CDSS) are important tools to improve health care outcomes and reduce preventable medical adverse events. However, the effectiveness and success of CDSS depend on their implementation context and usability in complex health care settings. As a result, usability design and validation, especially in real world clinical settings, are crucial aspects of successful CDSS implementations. ObjectiveOur objective was to develop a novel CDSS to help frontline nurses better manage critical symptom changes in hospitalized patients, hence reducing preventable failure to rescue cases. A robust user interface and implementation strategy that fit into existing workflows was key for the success of the CDSS. MethodsGuided by a formal usability evaluation framework, UFuRT (user, function, representation, and task analysis), we developed a high-level specification of the product that captures key usability requirements and is flexible to implement. We interviewed users of the proposed CDSS to identify requirements, listed functions, and operations the system must perform. We then designed visual and workflow representations of the product to perform the operations. The user interface and workflow design were evaluated via heuristic and end user performance evaluation. The heuristic evaluation was done after the first prototype, and its results were incorporated into the product before the end user evaluation was conducted. First, we recruited 4 evaluators with strong domain expertise to study the initial prototype. Heuristic violations were coded and rated for severity. Second, after development of the system, we assembled a panel of nurses, consisting of 3 licensed vocational nurses and 7 registered nurses, to evaluate the user interface and workflow via simulated use cases. We recorded whether each session was successfully completed and its completion time. Each nurse was asked to use the National Aeronautics and Space Administration (NASA) Task Load Index to self-evaluate the amount of cognitive and physical burden associated with using the device. ResultsA total of 83 heuristic violations were identified in the studies. The distribution of the heuristic violations and their average severity are reported. The nurse evaluators successfully completed all 30 sessions of the performance evaluations. All nurses were able to use the device after a single training session. On average, the nurses took 111 seconds (SD 30 seconds) to complete the simulated task. The NASA Task Load Index results indicated that the work overhead on the nurses was low. In fact, most of the burden measures were consistent with zero. The only potentially significant burden was temporal demand, which was consistent with the primary use case of the tool. ConclusionsThe evaluation has shown that our design was functional and met the requirements demanded by the nurses’ tight schedules and heavy workloads. The user interface embedded in the tool provided compelling utility to the nurse with minimal distraction.

BackgroundPublic adherence to cancer screening guidelines is poor. Patient confusion over multiple recommendations and modalities for cancer screening has been found to be a major barrier to screening adherence. Such problems will only increase as screening guidelines and timetables become individualized. Objective We propose to increase compliance with cancer screening through two-way rich media mobile messaging based on personalized risk assessment. MethodsWe propose to develop and test a product that will store algorithms required to personalize cancer screening in a central database managed by a rule-based workflow engine, and implemented via messaging to the patient’s mobile phone. We will conduct a randomized controlled trial focusing on prostate cancer screening to study the hypothesis that mobile reminders improve adherence to screening guidelines. We will also explore a secondary hypothesis that patients who reply to the messaging reminders are more engaged and at lower risk of non-adherence. We will conduct a randomized controlled trial in a sample of males between 40 and 75 years (eligible for prostate cancer screening) who are willing to receive text messages, email, or automated voice messages. Participants will be recruited from a primary care clinic and asked to schedule prostate cancer screening at the clinic within the next 3 weeks. The intervention group will receive reminders and confirmation communications for making an appointment, keeping the appointment, and reporting the test results back to the investigators. Three outcomes will be evaluated: (1) the proportion of participants who make an appointment with a physician following a mobile message reminder, (2) the proportion of participants who keep the appointment, and (3) the proportion of participants who report the results of the screening (via text or Web). ResultsThis is an ongoing project, supported by by a small business commercialization grant from the National Center for Advancing Translational Sciences of the National Institutes of Health. Conclusions We believe that the use of centralized databases and text messaging could improve adherence with screening guidelines. Furthermore, we anticipate this method of increasing patient engagement could be applied to a broad range of health issues, both inside and outside of the context of cancer. This project will be an important first step in determining the feasibility of personalized text messaging to improve long-term adherence to screening recommendations.

This article mainly uses two methods of solving the conservation laws of two partial differential equations and a system of equations. The first method is to construct the conservation law directly and the second method is to apply the Ibragimov method to solve the conservation laws of the target equation systems, which are constructed based on the symmetric rows of the target equation system. In this paper, we select two equations and an equation system, and we try to apply these two methods to the combined KdV-MKdV equation, the Klein-Gordon equation and the generalized coupled KdV equation, and simply verify them. The combined KdV-MKdV equation describes the wave propagation of bound particles, sound waves and thermal pulses. The Klein-Gordon equation describes the nonlinear sine-KG equation that simulates the motion of the Josephson junction, the rigid pendulum connected to the stretched wire, and the dislocations in the crystal. And the coupled KdV equation has also attracted a lot of research due to its importance in theoretical physics and many scientific applications. In the last part of the article, we try to briefly analyze the Hamiltonian structures and adjoint symmetries of the target equations, and calculate their linear soliton solutions.

In this paper, we consider how to find new exact solutions for nonlinear partial differential equations using the extended Kudryashov method. This method mainly uses the Riccati equation and the Bernoulli equation where there are some underdetermined constant parameters. And we also use the concept of symmetry to study its reduction equation, Lie transformation group, self-adjointness, and conservation laws. This paper mainly studies the Boussinesq class and the shallow water wave equation in (1 + 1) dimensions and tries to find new exact solutions and symmetry properties of them.

A new three-dimensional Lie algebra and its loop algebra are proposed by us, whose commutator is a vector product. Based on this, a positive flow and a negative flow are obtained by introducing a new kind of spectral problem expressed by the vector product, which reduces to a generalized KdV equation, a generalized Schrödinger equation, a sine-Gordon equation, and a sinh-Gordon equation. Next, the well-known Tu scheme is generalized for generating isospectral integrable hierarchies and non-isospectral integrable hierarchies. It is important that we make use of the variational method to create a new vector-product trace identity for which the Hamiltonian structure of the isospectral integrable hierarchy presented in the paper is worded out. Finally, we further enlarge the three-dimensional loop algebra into a six-dimensional loop algebra so that a new isospectral integrable hierarchy which is a type of extended integrable model is produced whose bi-Hamiltonian structure is also derived from the vector-product trace identity. This new approach presented in the paper possesses extensive applications in the aspect of generating integrable hierarchies of evolution equations.

Developing Business Intelligence (BI) has been a top priority for enterprise executives in recent years. To meet these demands, universities need to prepare students to work with BI in enterprise settings. In this study, we considered a business simulator that offers students opportunities to apply BI and make top-management decisions in a system used by real-world professionals. The simulation-based instruction can be effective only if students are not discouraged by the difficulty of using the BI computer system and comprehending the complex BI subjects. Constructivist practices embedded in the business simulation are investigated to understand their potentials for helping the students to overcome the perceived difficulty. Consequently, it would enable instructors to more efficiently use the simulator by providing insights on its pedagogical practices. Our findings showed that the constructivist practices such as collaboration and subject integration positively influence active learning and meaningful learning respectively. In turn, both active learning and meaningful learning positively influence business intelligence motivational behavior. These findings can be further used to develop a robust learning environment in BI classes.

To assess the effectiveness of three-level prevention and control of thalassemia, we routinely collect samples from transfusion-dependent individuals and perform genetic analysis. Here, we report on a 10-year-old boy requiring blood transfusions with routine thalassemia gene test results of αα/αα, and βCD41/42/βN, but he had thalassemia-like changes in his appearance and a high need for frequent blood transfusions, suggesting a case of thalassemia major in childhood. Given these equivocal results, samples from the family members were collected for further analysis. A multiplex ligation-dependent probe amplification assay was used to detect a multicopy number variant of the α globin gene cluster in the proband. The variant was detected as a long fragment repeat of 380 Kb using CNV assay technique, which contains the entire α globin gene cluster, describing it as αααα380/αα. Analysis of family members suggested that both the brother and mother of the proband carried the variant, and both MCV and MCH values were reduced in carriers. Individuals carrying multiple copy number variants of the α globin gene cluster exist in the population. Individuals carrying such variants who are also heterozygous for the β0 thalassemia variant result in an imbalance in the α/β chain ratio, potentially leading to the creation of individuals with a severe anemia genotype. Most secondary prevention and control laboratories currently do not include variants with increased α gene copy number in their testing, which is one of the blind spots of prevention and control efforts. In order to provide more accurate genetic counseling to test subjects, especially in regions with high rates of thalassemia carriage, testing laboratories should pay attention to individual genotype-phenotype matches to avoid the under-detection of such variants. [ABSTRACT FROM AUTHOR]

Open Source Software (OSS) is a major force in today's Information Technology (IT) landscape. Companies are increasingly using OSS in mission-critical applications. The transparency of the OSS technology itself with openly available source codes makes it ideal for students to participate in the OSS project development. OSS can provide unique opportunities for students to learn and develop their software project development skills. From an educator's perspective, we argue that it is beneficial for the students' career prospects if OSS experiences are included in the students' resumes. This research is to test these hypotheses from the potential employers' perspective. We set out to examine the following research questions: First, do the potential employers value the students' OSS development experience? Second, what are the factors that potential employers look for when assessing students' OSS experience? To answer these questions, we surveyed a large sample of CIO/CTOs, project managers, and developers from various technology companies. Most of our respondents had been involved in the corporate hiring process and most were familiar with OSS. Based on the analysis, we found that OSS related experience could have a positive effect on students' career development. Our respondents rated OSS-related experience as being as valuable as experience gained through proprietary software projects. Crucial factors employers look for include whether the OSS projects are supported or compatible with the hiring companies' practices. In addition, experience focusing on programming and architecting were regarded as valuable. Our research is potentially of value to IT educators when they advise students on career development. It also offers insight to IT practitioners when evaluating student applicants with OSS experience. (Contains 6 figures.)

Improving learning effectiveness has always been a constant challenge in software education and training. One of the primary tasks educators face is to motivate learners to perform to their best abilities. Using computer games is one means to encourage learners to learn (Klawe, 1994). When games are used in general education, they could enhance self-esteem for the learners, reduce training time and instructor load, provide more opportunities for practice and enhance knowledge acquisition (Brownfield & Vik, 1983; Ricci, 1994). Moreover, researchers have noted many benefits of using computer games in IT education as well. For instance, it has been shown that a game-based environment is more enjoyable to the users than a traditional environment in IT training (Venkatesh, 1999). In this study, we focused on one game: IBM Robocode. We examined the characteristics of Robocode and the Robocode community. We addressed the following research questions: (1) How did the Robocode game influence the participant's learning outcomes? Did the participant's programming skills and knowledge improve after playing the Robocode game? (2) Was the Robocode game enjoyable to participants with different ages, education and skill levels? (3) What did the participants like the most about the Robocode game? (4) What were the factors that influence the participant's motivation? (5) What activities of the game were more enjoyable? To answer these questions, we conducted a survey of Robocode participants. Our sample was randomly drawn from the online forum of the Robocode community. We sent out a total of 500 surveys and generated 83 valid responses. Regarding the effectiveness in learning new programming skills using Robocode, we found that about 80% of the participants' programming skills increased after playing Robocode. We also found that Robocode was enjoyable not only to younger participants but also to older--and often more experienced--participants. Our results also showed that participants in various education levels and expertise levels all enjoyed Robocode. Examining the motivation for the learners to participate in the game, we found that to have fun (an intrinsic motivator) was the most common reason. Another important factor, also an intrinsic motivator, was the opportunity to learn new programming skills. Extrinsic motivators, such as "to win the game", "to win the prize in the contest" and "to gain peer recognition", proved to be far less significant. Furthermore, we examined the factors that made Robocode fun. Among the factors listed, "to be able to solve problems on my own" was chosen most frequently. "To be able to be creative" was identified as the second most important factor. Both factors are most closely related to the autonomy category of intrinsic motivation. "To be able to put skills in use" and "to be able to learn new skills" were also selected as important factors. Both factors could be classified as competence motivators. Our results are consistent with the previous theories on motivation that the more autonomy and competence the learner has, the more fun the learning process. We also found that the Robocode participants enjoyed some activities of the game more than other activities. Among the Robocode activities, discovering algorithms was chosen as the most enjoyable. Designing the architecture was highly enjoyable as well. On the other hand, writing the code and testing and debugging were less enjoyable. Our research could provide a better understanding of how to incorporate Robocode and similar games in software programming education. The results from our study could be valuable not only to practitioners, but also to researchers examining the methods to improve software education and training. Instructors hoping to improve learning outcomes could leverage a programming game such as Robocode as an education and training tool to enhance the learning experiences and outcomes. It might also be interesting to broaden the scope and utilize Robocode or similar games in higher-level courses, or even graduate courses. (Contains 2 figures and 8 tables.)

Thalassemia is a single-gene genetic disease with a high incidence in southern China. To prevent and control thalassemia, the most commonly used procedure is hematology testing and hemoglobin (Hb) analysis, followed by thalassemia gene analysis in positive individuals. During routine testing for thalassemia, we identified three individuals with Hb A2 levels of >10.0%. The results of conventional thalassemia gene analysis of these individuals cannot explain this feature, and there is a possibility of carrying novel thalassemia gene variants. Therefore, we collected samples from these three families for further analysis of the thalassemia gene. The research team used multiplex ligation-dependent probe amplification (MLPA) to analyze the three families, and the analysis results showed that their molecular biological characteristics were similar to those of Hb Anti-Lepore Hong Kong (NG_000007.3: g.63210_70621dup). Then, gap-polymerase chain reaction (gap-PCR) and sequencing methods were used for verification, and it was confirmed that the variant carried by these three families was indeed Hb Anti-Lepore Hong Kong. Three individuals carrying both the – –SEA (Southeast Asian) and Hb Anti-Lepore Hong Kong variants were also detected in this study, and these individuals had slightly lower Hb A2 results than those carrying Hb Anti-Lepore Hong Kong alone. Further analyses revealed that the carrier rate of this variant is about 0.03% in the population, thus identifying it as a rare variant. [ABSTRACT FROM AUTHOR]